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What specific positioning error causes the left iliac wing to appear more narrowed than the right in an AP abdomen?

  1. Patient rotated into a slight RPO

  2. Excessive left tilt

  3. Insufficient right tilt

  4. Patient's legs not positioned correctly

The correct answer is: Patient rotated into a slight RPO

When evaluating the appearance of the iliac wings in an AP abdomen radiograph, the narrowing of one side compared to the other indicates a rotational positioning error. In this case, if the left iliac wing appears more narrowed than the right, it is due to the patient being rotated slightly into a right posterior oblique (RPO) position. This rotation causes the left iliac wing to become more foreshortened, leading to the visual perception of narrowing. In a proper AP position, the iliac wings should be symmetrical. However, rotation of the patient results in one side appearing larger or more prominent than the other, depending on the direction of the rotation. A slight rotation toward the right posterior side would shift the overall anatomy, affecting the shape and visibility of the left iliac wing specifically. Understanding this concept is crucial for radiographers to ensure the proper positioning of patients during imaging, as it directly affects the interpretation of the images by radiologists. Proper positioning helps in obtaining accurate and diagnostic-quality radiographs, minimizing errors that could lead to misdiagnosis.